Wow! Time here has definitely flown by!  I feel like there is so much more to learn and see!  I have loved staying at St. Gabriel’s.  All the staff here are so friendly to us.  It has been great living with other volunteers in the guesthouse.  The lessons I have learned here will empower me to be a more passionate and dedicated student, physician and friend.

I will always remember the children of Malawi.  Since I came here two years ago, the children have had a special place in my heart.  There is nothing like seeing a smile on a Malawian child, whether they are playing with their friends, working in the field, or staying in the pediatric ward.

My time in the labour ward was also extremely rewarding.   Recently, the Malawian government has begun enforcing a rule that all mothers must give birth in a hospital, or the chief of their village fines them. The major problems during childbirth include: hemorrhage, pre-eclampsia and eclampsia, sepsis, prolonged/obstructed labor, ectopic pregnancy and complications with abortions.  Mortality of neonates due to preventable causes occurs much too frequently here, and seems to be an accepted part of life.  This must change.  Pregnant mothers must be monitored more closely and antenatal care must be non-negotiable! The risk of death due to pre-eclampsia and eclampsia can drastically reduced, but here it requires the attentive care of health workers to monitor blood pressure of moms through the antenatal period.  The same is true for neonatal morbidity due to maternal malaria and anemia.  Proper antenatal care ensures that mothers are tested for transmittable diseases such as syphilis and HIV, are given prenatal vitamins, and are educated regarding how to care for their developing baby and ensure a safe delivery.  Stigmas for procedures such as c-sections and preventative measures for transmitting HIV to their babies must be overcome through education. Furthermore, fathers must be involved in the entire pregnancy by attending each antenatal care visit and staying with the mother at the hospital during the birth.  Currently, most Malawian fathers are involved in no more than the conception of the baby.  This leads to unsafe work and stress for the mother, which leads to increased risk for the unborn baby.  If the father knew how difficult the birthing process was for the mother, instead of simply thinking she goes away for a week and returns from the hospital with a child, he would be more willing to think about her health and be more apt to play a role in family planning.

So many things we take for granted as patients in America are completely unheard of here.  People are grateful just to be in the hospital. They never demand to be seen immediately by a physician.  I never saw a rude patient. In the wards, each patient comes with a caregiver.  This person cooks all their meals for them in the hospital’s kitchen and brings them to the patient.  There is absolutely no temperature control in the wards.

I am prepared to have quite a bit of reverse culture shock upon returning, but I am going to try my best not to get TOO frustrated when facing encounters with the American sense of entitlement.

Many of the community health workers are volunteers!  They don’t work for pay, rather for knowledge and for an identity as one who provides care to others!  That is an identity worth striving for! To be a person who cares tirelessly for the people in their community simply to be known for doing so.  What an impression to leave on the world!

This experience has reminded me that I can never allow myself to become complacent.  It is too easy to keep the needs I have seen here distanced from my American life, but this is not what I have been called to do.   I do not know where my future career as a physician will take me or who it will lead me to help, but I have seen so many needs, for both global health technologies and caring health professionals, and I desire to play a role in meeting these needs.

This trip has been so good for me.  I have learned the value of true friendship and been so blessed by the many people I have met.  I have learned to have more trust, to value the slow joys of life- even if they don’t “accomplish” anything, and to have more patience- unnecessary rushing does nothing but add stress.

It’s not always what we do, but the attitude we do it with!  A radiating smile improves the day for everyone who sees it!  When we find it hard to measure the success of a smile or a encouraging conversation given to a friend or patient, I think the problem is simply with our measuring tool!

Until next time…tionana Malawi!